Skin autofluorescence and the complexity of complications in patients with type 2 diabetes mellitus: a cross-sectional study

Abstract

Background The accumulation of advanced glycation end products (AGEs) occurring in skin tissues can be measured as skin autofluorescence (SAF). Here, we assessed the correlation between SAF values and the complexity and severity of type 2 diabetes mellitus (T2DM) complications. Methods The basic clinical information of 825 patients with T2DM was collected through an electronic system, and SAF was measured by adapting a DM-Scan, a non-invasive optical signal detector. Diabetic complications were diagnosed based on clinical criteria by experienced doctors. Linear regression analysis was used to evaluate the independent determinants of SAF, and multiple logistic regression analysis was performed to assess independent determinants that influence the severity of the complications. Results SAF was significantly associated with the complexity of T2DM complications. Similarly, independent relationships between SAF and age (β = 0.389, P < 0.001), sex (β = − 2.221, P = 0.004), 2-h C-peptide (β = − 0.182, P = 0.017), aminotransferase (ALT, β = − 0.158, P = 0.041), blood creatinine (BCr, β = 0.206, P = 0.009), and fatty liver (β = 0.161, P = 0.026) were observed. With the increasing number of complications, the SAF values increased significantly after adjusting for related risk factors. The SAF values correlated with diabetic retinopathy, diabetic kidney diseases, cardiovascular disease, and diabetic peripheral neuropathy when compared with patients without any T2DM-associated complications. Moreover, the AGE-based diabetic complication risk score for each complication demonstrated a relationship with the presence or absence of certain complications. Conclusion SAF is an independent marker for diabetic retinopathy, diabetic kidney diseases, cardiovascular disease, and diabetic peripheral neuropathy, and it is also a predictor of the complexity of T2DM complications. Moreover, the diabetic complication risk score is capable of predicting the risk of diabetic complications in patients with T2DM.

Skin Advanced Glycation End Products among Subjects with Type 2 Diabetes Mellitus with or without Distal Sensorimotor Polyneuropathy

“…Our findings are in line with previous reports [ 17 – 22 ]. Indeed, in a multicentre study including 497 participants with diabetes mellitus (including both diabetes types), a significant increase in skin AGEs was seen in the presence of DSPN (defined using the Toronto Clinical Neuropathy Score, the Neuropathy Symptom Score, and the NDS) [ 17 ].…”

Is skin autofluorescence a novel non-invasive marker in diabetes? A systematic review and meta-analysis of case–control studies

“…In a previous study, no significant variation was observed between the five groups at baseline in terms of BMI. [ 51 ] This may be because the study's greater sample size was what caused the majority of the disparity. In a different research, participants exposed to various health risk factors also had greater BMI, which was related to increased AGE accumulation.…”

Role of Advanced Glycation End Products in Assessment of Diabetes Mellitus as a Risk Factor for Retinal Vein Occlusion

“…AGE-related crosslinking and receptor-mediated cellular activation lead to the loss of elasticity of the vascular wall and inflammation, which can result in microvascular and macrovascular complications. Therefore, AGEs are perceived as potential biomarkers for the progression of possible changes in DM [48][49][50].…”